Walnut Creek Elder Law Blog

The VA Aid & Attendance Pension Benefit is available for wartime veterans or their surviving spouses. For 2011, a single veteran can receive up to $1,644 per month, and $1,949 if married. The widowed spouse can receive up to $1,056 per month. This benefit is most helpful for payment of in home care, assisted living facility and board and care costs.

For qualification, the VA takes into account, among other things, income and assets. If the applicant’s income and assets are too high, he may not qualify. That is where planning by your elder law attorney, who is certified by the VA, comes in. In addition, when we plan for the VA Aid & Attendance Pension Benefit, we also plan for Medi-Cal benefits at the same time. Medi-Cal pays for nursing home costs after your Medicare days are used up. Nursing homes in our area can cost upwards of $7,500 or more per month. If you plan for VA alone, without taking into account the more stringent Medi-Cal rules at the same time, you may become eligible for VA but ineligible for Medi-Cal.

Beware of being asked to purchase an annuity to qualify for VA. We have been informed by clients and others that there are annuity salesmen out there, who are also usually not certified by the VA, who will ask you to purchase an annuity for VA qualification. I understand that they usually do not tell you about the annuity at first. The purpose for the sale of an annuity, from a legal perspective, is at best unclear, and is generally viewed by the elder law legal community as unnecessary.  Your elder law attorney can best help you with asset protection and planning, within the Medi-Cal and VA regulations, without the sale of annuities. Medi-Cal also has stringent requirements about annuities, which could make the Medi-Cal applicant either ineligible for Medi-Cal, or require him to pay more than necessary in the share of cost, which money goes from the applicant to the nursing home.  We receive calls from individuals, and their families, who are quite angry that they have purchased an annuity for VA qualification, angry that they do not understand what the purpose of the annuity was, and would like to know how to reverse the process. Your elder law attorney, who is certified by the VA, can best help you with long term care planning, asset protection, VA and Medi-Cal qualification, and estate planning at the same time, legitimately and within the regulations.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

This information is not to be taken as legal advice, and you are encouraged to see an elder law attorney for professional advice.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

This information is not to be taken as legal advice, and you are encouraged to see an elder law attorney, who is certified by the VA, for professional advice.

I can’t help myself talking about our grandkids, at least one more time. My wife and I have two grandchildren, a boy 4 and a girl 2 ½. Both kids “stayed over” a couple of weekends ago. They arrived on Saturday morning with their little suitcases packed, which included their swimsuits. They wanted to swim with us in our community pool, but that plan was thwarted when we found out the pool pump was broken.

We felt horrible, and did not have a little pool for them. What we did have was a large plastic storage container, which held about 20 gallons of water. We also had large and small “Super Soaker” squirt guns, and Grandma had all sizes of plastic measuring cups. The kids put their swim suits on, filled the storage container with water, and climbed inside the container! They played with the hose, the squirt guns and the measuring cups for hours. Every once in awhile they would climb out of the container and lie on their towels in the sun to dry off. When they were dry they would climb back into the container and have more fun! I guess we don’t really need a pool, but I am off to Target to find something for them to use at our house.

There is probably no legal point to all of this, (other than to include your grandchildren in your estate plans) but I just had to share with you how fun it is being grandparents!  

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

This information is not to be taken as legal advice, and you are encouraged to see an elder law attorney for professional advice.

When I was younger and people started to talk about their grandchildren, I would practically plug my ears. Now that we have two grandchildren, ages 4 and 2, I am the one who can’t stop talking about them.

So, since I can’t stop myself, I must tell you a story about my granddaughter, Edie. She will be 3 this coming September. Grandma and I were watching both grandchildren a few weekends ago, and Edie was on my lap. I was opening a package that came in the mail, and when I opened the package, bubble wrap came out. My granddaughter said to me, “BaPa, cut a small piece for me.” So I cut a small piece for her and said, “Like this?” She said, “Yes, not pop it! Pop it! Pop It!” I started to pop the little bubbles for her, and she couldn’t stop laughing. It made me laugh that she was laughting, and I was also laughing at how this little girl could give me orders which I would immediately comply with.

I felt like my life was made at that moment. My granddaughter and I were both happy and laughing. I was also astonished that this little girl at age 2  1/2 would know about these things and could tell me what to do like that! I just can’t imagine that other grandchildren are that smart. (ha ha)

I hope you didn’t plug your ears. Thank you, BaPa, Mike Young.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

This information is not to be taken as legal advice, and you are encouraged to see an elder law attorney for professional advice.

     Medicare is a Federal health insurance program. Social Security funds are used to pay the costs of the program. Individuals who are over the age of 65, and who have made Social Secuirty contributions during their working lives are entitled to benefits. Part A of Medicare pays for hospitalization, hospice and some health care. It also pays for rehabilitation in a nursing home for specific periods of time. Part B is designed to pay for outpatient hospital care and doctors’ visits. Co-payments, deductibles and monthly payments may be required for Part B.  

     If a person is hospitalized for three days under Medicare, and then goes into a skilled nursing facility (SNF), Medicare will pay pay 100% of the bill for up to 20 days in the SNF. After that, for days 21 to 100, Medicare will pay only for 80% of the cost. During this time, the Medicare recipient will be required to make a co-payment, through supplemental insurance or will pay privately.

    After 100 days, there is no Medicare coverage for a SNF. After that time, you must pay privately, pay through your long term insurance policy (if  you have one) , or qualify for Medi-Cal to pay for the SNF. The average stay in a SNF under Medicare is under 24 days. Medicare and Medi-Cal are two different programs, and are not related to each other.

     Planning for Medi-Cal qualification should be made early on, through your elder law attorney. There are qualification requirements with regard to assets, income,  spending down, gifting, and a share of cost which goes to the the nursing home. There are legitimate and legal methods through the Medi-Cal regulations to protect assets and create qualification for Medi-Cal. You may visit our web site at htt://WalnutCreekElderLaw.com, for information on how to plan for and how to qualify for Medi-Cal. The estate planning documents, including the financial durable powers of attorney and revocable living trust are usually updated to include government benefits and asset protection language. If a client loses mental capacity, and this language is not present in the estate planning documents, qualification for government benefits, including Medi-Cal, and asset protection is much more difficult.

 Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young, who also advises on Medi-Cal qualification, asset protection, nursing homes and the VA Aid & Attendance qualification, serves Contra Costa and Alameda Counties in CA, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

The language used in estate planning documents for asset protection and government benefits planning for the older client, is very different from the language used in regular estate planning documents. In fact, I would say that 90% or more of all revocable living trusts and financial durable powers of attorney do not contain the right language, and are defective for this type of planning, if the maker or one of the makers of the documents loses mental capacity.

As an example, if we are going to protect the home from a Medi-Cal lien, because of an imminent stay in a nursing home, we may want to transfer the ill spouse’s interest in the home to the well spouse. Or, in the case of a single person, we may want to transfer that person’s interest in the home to a child. Or, we may want to liquidate the cash in value of a life insurance policy, and gift that interest to a spouse or a child.

If the person who owns the interest has lost capacity to make the transfer, the language in the trust and financial durable power of attorney, in most cases, does not allow for this type of transfer. As a result, we may have to go to court to obtain an order to reform the estate planning documents. This process can be costly.

The alternative is to do pre-planning, and have the revocable living trust and financial durable powers of attorney updated by an elder law lawyer, who practices in the areas of Medi-Cal planning, VA planning and nursing home planning. By doing pre-planning, and including the correct language in these documents, we can save costs and headaches later on.       

This blog is for informational purposes only and is not legal advice. You should consult an elder law, asset protection and government benefits attorney for your particular case, and before you proceed with any planning.

Written Michael J. Young, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Mr. Young advises clients regarding Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning.

When we plan for the VA Aid and Attendance Pension benefit, we plan for Medi-Cal at the same time. Medi-Cal and the VA benefit are both asset and income based programs. Medi-Cal pays for the costs of skilled nursing facilities, minus the share of cost paid by the recipient. The VA benefit can help pay for the costs of assisted living facilities, board and care facilities, and in home care costs. Under both programs, if the applicant is “over assets”, they can spend down, gift some of their assets away, or use other legitimate asset protection techniques to obtain qualification. 

The VA Aid and Attendance Pension Benefit program does not have a “look back” penalty period. The applicant could give away $50,000 for instance, today, and theoretically be eligible for the VA benefit tomorrow. If the same applicant then went to apply for Medi-Cal, after having gifted the $50,000, there would be an eight month penalty period. Divide $50,000 by $5,698 (penalty divisor) and you have 8.775 or, rounded down, eight months of ineligibility. As a result, the applicant would not be eligible for Medi-Cal for eight months.

There are legitimate gifting and planning techniques which your elder law attorney can show you to  create fewer months of ineligibiity for Medi-Cal. Remember that Medi-Cal pays for skilled nursing, which is much more expensive than assisted living facilities. Planning for Medi-Cal and the VA Aid and Attendance Pension benefit at the same time, is good planning. Your Medi-Cal, elder law attorney can help you with this.

 Written Michael J. Young, elder law and asset protection attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa County and Alameda County, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Medi-Cal Attorney Contra Costa.

If you die after having been on Medi-Cal, the State can pursue a claim against your estate for recoupment of the money they paid to the nursing home. But, if there are no assets in your estate when you die, there will be nothing for the State to recover. The State will not pursue a claim however while the surviving spouse is alive. There are also exemptions if there is a minor, blind or disabled child of the recipient, living at the time of the recipient’s death.

 It is a common misconception that the revocable living trust of the recipient provides protection against a State lien. California will pursue claims against assets in living trusts. They will also pursue claims against joint tenancy interests and tenants in common, for instance. The amount of the potential recovery is limited to the amount of the benefits paid by Medi-Cal, or the value of the recipient’s estate, whichever is less. If your home is encumbered by a mortgage, this will reduce the available equity the State could pursue.

 An elder law attorney who is familiar with the Medi-Cal rules and regulations, can help you qualify for Medi-Cal, and can help you legally arrange your assets so that they will not be susceptible to a lien after you die. This process will also allow you to preserve your assets for a longer period of time while you are live. Remember, that if you run out of money, you run out of options.

 By Michael J. Young, Elder Law Attorney.

 Mr. Young practices elder law in Contra Costa County, and his office is located at 1931 San Miguel Dr., Ste., 220, Walnut Creek CA 94596. (925)-256-0298. He advises clients in cities such as Walnut Creek, Concord, Danville, Alamo, Antioch and Brentwood. You may visit his website at www.WalnutCreekElderLaw.com.  Mr. Young helps clients qualify for Medi-Cal benefits to pay for nursing home costs. He also helps clients qualify for the V.A. Aid & Attendance pension benefit for wartime veterans to help pay for in-home care. Many of Mr. Young’s clients are Alzheimer’s or Parkinsons’s disease patients.

Parkinson’s disease is a brain disorder, wherein certain nerve cells in the brain become impaired or die. These nerve cells, called “neurons” normally produce a chemical known as dopamine. This chemical allows for smooth, coordinated functions of the body’s muscles and movements.

When a high percentage of the brain cells which produce dopamine are impaired, symptoms of Parkinson’s disease may appear. Symptoms may include tremors, changes in facial expression, imbalance, small handwriting and slowness of movement. In time, the symptoms may become worse. Mild tremors can become more severe. Body movements may also become slower, and mobility problems may become worse. The use of eating utensils, dressing, and performing various activities of daily living may become more difficult.

Parkinson’s disease, which is difficult to diagnose officially, affects both sexes in equal numbers, and does not discriminate on the basis of ethnicity, social status or where you live. There are different rates of progression for the disease. We encourage our clients who have Parkinson’s disease and their familiy members to seek the help of support groups, to pursue ongoing medical care, and to learn adaptive techniques from medical professionals.

 Parkinson’s disease is the most common brain disorder, after Alzheimer’s disease, that we see with our clients. When symptoms of Parkinson’s disease appear, as with symptoms of Alzheimer’s disease, we receive inquiries from individuals who may have the disease, or from their loved ones. They want know what should be done now regarding the establishment of a long term care plan for the person with the disease.

We help clients review and update their existing estate planning documents, to be sure the documents contain the requisite asset protection language. We then help the family plan for long term in-home care, which is the preference of most of our clients. We help the family plan for the VA Aid and Attendance benefit, which can help pay for in home care, for veterans. We also help with planning for Medi-Cal benefits, which can pay for nursing home care.   

 If you or a loved one has symptoms of Parkinson’s disease, please feel free to call elder law attorney Michael J. Young, with offices in Walnut Creek, CA, at 925-256-0298. Mr. Young serves clients principally in Contra Costa and Alameda Counties. You can visit our web site at www.WalnutCreekElderLaw.com

It is not a requirement that the Veteran purchase an annuity and/or sell his home in order to qualify for the VA “Aid and Attendance” benefit. And, in the majority of cases, neither is necessary. An elder law attorney who deals in this area of planning, will in most instances be accredited by the VA to file claims for their clients. We receive calls from family members who complain bitterly that they sold their parents’ home and bought an annuity at the advice of someone, to obtain qualification for VA benefits. They find out later that the purchase of an annuity and sale of the home were both unnecessary. The Veterans Administration has a non-service connected benefit available as a potential source of funds to help pay for long-term care costs for the disabled veteran who is at home or in an assisted living facility. It is a program called “Aid and Attendance”, and is available for Vets who are disabled due to the issues of old age, such as physical disabilities, Alzheimer’s, Parkinson’s or multiple sclerosis. The Vet needs to show that he is in need of regular aid and attendance on a regular basis. Needing help with various “activiities of dailly living”, is a good measure of the test. A Vet who is housebound or in an assisted living facility and who is over 65 is presumed eligible for the benefit. A Veteran can receive up to $1,801 per month, and a widow or widower can receive up to $976 per month. There are asset and income requirements. When planning for VA benefits, you must also plan for Medi-Cal benefits at the same time. There is no “look back period” for gifting under VA rules, but there is a “look back period” under Medi-Cal rules. A big transfer of assets to create eligibility for the VA benefit could make the older person ineligibile for Medi-Cal benefits. The home is exempt for qualification under both benefits, so there is no need to sell the home. The home can be protected, however, from a Medi-Cal lien after the death of the recipient. The purchase of an annuity to create eligibility for VA benefits, could make the older person ineligible for Medi-Cal benefits. The annuity may not fit within Medi-Cal guidelines, and could be treated by Medi-Cal as a transfer of assets. Moreover, and more importantly, although not all annuities are bad or unnecessary, the purchase of an annuity, may not be necessary at all. When seeking help to obtain the VA benefit, ask if the person helping you has VA accreditation to file claims. A fee cannot be charged for filing a VA claim, and elder law attorneys will pursue the claim on a pro bono basis. Usually, the VA benefit is only part of long term care planning for the elder client, which will also involve asset protection, disability planning and Medi-Cal planning. Before purchasing an annuity, or any product as part of VA planning, and certainly before you sell the home, it is good advice to contact an elder law attorney for a review. You can see more on this subject in several of my Elder Law Today newsletters as follows: A VA Benefit for Long Term Care Pt. 1 – And to be 85 Again”>A VA Benefit for Long Term Care Pt. 1 – And to be 85 Again VA Benefits May Cover the Cost of an Assisted Living Facility or In Home Care A VA Benefit for Long Term Care Pt. 2 – And Back to Work After the War You can see additional information on this and other subject at my website at WalnutCreekElderLaw.com.